Healthcare Provider Details

I. General information

NPI: 1669458030
Provider Name (Legal Business Name): THOMAS R. WARREN II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE
APO AA
20889
US

IV. Provider business mailing address

8901 WISCONSIN AVE
APO AA
20889
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberJ8824
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberJ8824
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: